丙型肝炎病毒感染与肾小球肾炎  

IS THERE HEPATITIS C VIRUS ASSOCIATED GLOMERULONEPHRITIS?

作　　者：王海燕[1] 王丽[1] 张国庆[1] 席宏丽[1] 

机构地区：[1]北京医科大学第一医院肾脏内科,北京医科大学传染科病毒研究室

出　　处：《中华内科杂志》1994年第6期402-404,共3页Chinese Journal of Internal Medicine

摘　　要：自１９８９年首次分离出丙型肝炎ＲＮＡ病毒以来，人们也重视丙型肝炎病毒与肾脏疾病的关系。我们首先采用酶联免疫法检测５７０例经肾活检证实肾小球肾炎患者血清及１００例健康献血员血清的抗丙型肝炎病毒抗体（抗ＨＣＶ）．又用聚合酶链反应（ＰＣＲ）法对血清抗ＨＣＶ阳性患者进行了血清ＨＣＶ一ＲＮＡ检测。肾炎患者血清的抗ＨＣＶ阳性者为３４例（６％）；抗ＨＣＶ与乙型肝炎表面阳性标志物同时存在者为２例。抗ＨＣＶ阳性在各型肾小球病理损伤中的阳性例数与正常对照及其余病理损伤组比较，差异有显著性（Ｐ＜０．０５）；而抗体阳性３４例中ＨＣＶ一ＲＮＡ阳性者２１例，亦广泛分布于各型肾小球疾病中。抗ＨＣＶ阳性的３４例患者均以蛋白尿为主要表现，血肌酐增高者９例，ＡＬＴ增高者６例，血清补体Ｃ＿３降低者４例。本资料表明ＨＣＶ感染伴随之肾脏病理改变不均一，似以新月体肾炎、微小病变肾病、局灶节段性肾小球硬化病理类型ＨＣＶ感染的可能性更大。提示ＨＣＶ感染与某种肾小球疾病之间无肯定的致病关系（包括膜增生性肾炎），似以２种疾病同时并存的可能性大。epatitis C virus(HCV)infection is one ofthe important causes ofchronic and severe hepatitis in China.In an attempt to understand if there is any relationship between HCV infection and glomerulonephritis(GN), serum samples from 570 GN patients and 100 normal volunteers were screened for anti一HCV antibody(HCV一Ab) with ELISA method.Among the cases with positive HCV一Ab, serum HCV一RNA was tested With nested RT一PCR method. The incidence of serum HCV一Ab was 2 in 100 normal volunteers(2%)and 34 in 570 GN patients(6%).The incidence of posi-tive serum HCV一RNA was 0 in normal volunteers whereas 21 in GN patients. The main clinical mani-festation of GN patients with serum positive HCV一Ab was an unique proteinuria with/without nephrotic syndrome or renal failure, whereas the pathologic lesions in GN patients with serum positive HCV一Ab or HCV一RNA consisted of different disease entities.There was no close link between MPGN and active HCV infection. From the data observed, it seems that there is a coincidence between glomerular diseases and HCV infection rather than a matter of cause and consequence.

关 键 词：肾小球肾炎 丙型肝炎病毒 感染 

分 类 号：R692.310.2[医药卫生—泌尿科学]